australia's health system Flashcards
(19 cards)
health system
The World Health Organization (WHO) defines a health system as:
- ‘all the activities whose primary purpose is to promote, restore and/or maintain health’,
- And identifies that an effective healthcare system is one that is able to deliver quality healthcare services to all people when and where they are required.
the australian health care system includes many service providers, such as:
- doctors
- nurses
- specialists
- other health
professionals - hospitals
- clinics
- preventative health
programs - research centres
- pharmaceutical
companies - private health
insurance companies
Australia’s health system is made up of two main components:
- public health care
- private health care
the public sector includes
- public hospitals
- medicare
- PBS
- NDIS
the private sector includes
- private health insurance
- private hospitals
- medical practitioners in private practice
The public component of australias health system includes
The public component includes public-sector health services and schemes that are provided by the:
- Australian (Federal)
- State/territory
- Local governments
This includes public hospitals, Medicare,
the Pharmaceutical Benefits Scheme (PBS)
and the National Disability Insurance Scheme (NDIS).
medicare
- Medicare is Australia’s universal health insurance scheme.
- Established in 1984 Medicare gives all Australians, permanent residents and people from countries with a reciprocal agreement (New Zealand, the United Kingdom, the Republic of Ireland, Belgium, Sweden, the Netherlands, Finland, Italy, Malta, Slovenia and Norway) access to healthcare that is subsidised by the government.
Medicare - How is it funded?
- The Medicare levy
- The Medicare levy surcharge
- General taxation
FUNDING:
The medicare levy
Medicare is funded by the Commonwealth Government partly through contributions made to the healthcare system through a 2 per cent Medicare levy, which is paid by most taxpayers who earn over a certain amount and based on taxable income.
FUNDING:
The medicare levy surcharge
- People without private health insurance earning more than a certain amount ($90,000 a year for individuals and $180,000 for families in 2017–18) have to pay an extra tax called the Medicare levy surcharge.
- The Medicare levy surcharge increases as income increases
FUNDING:
general taxation
- The revenue collected from the Medicare levy and the Medicare levy surcharge does not meet the full operating costs of Medicare. Therefore, income collected through general taxation is also used to help fund the cost of Medicare.
medicare safety net
- The Medicare Safety Net provides extra financial assistance for those that incur significant out-of-pocket costs for Medicare services.
- Once an individual or family has contributed a certain amount out of their own pocket to Medicare services in a calendar year ($560.40 in 2024), further financial support is provided by the government, making Medicare services cheaper for the remainder of that year.
what does medicare cover?
- in hospital and put of hospital services
- free or subsidised treatment by GP’s and optometrists
- certain daignostic tests
what does medicare NOT cover?
- ambulance services
- in home nursing care
- most private hospital care
- most dental examinations and treatment
- hearing aids
schedule fee
schedule fee the amount of money that the government deems appropriate for a particular medical service or procedure
co-payment
patient co-payment the payment made by the consumer for health products or services in addition to the amount paid by the government
bulk bill
bulk-billed when the doctor charges only the schedule fee. The payment is claimed directly from Medicare so there are no out-of-pocket expenses for the patient.
If the doctor bills Medicare directly, this is known as ‘bulk-billing’ and means that the doctor accepts the Medicare payment as full payment for the service. This means there is no cost to the patient.
medicare advantages
- Choice of doctor for out-of-hospital services
- Available to all Australian citizens
- Reciprocal agreement between Australia and other countries allows Australian citizens to access free health care in selected countries
- Covers tests and examinations, doctors’ and specialists’ fees (schedule fee only), and some procedures such as X-rays and eye tests
- The Medicare Safety Net provides extra financial contributions for medical services once an individual’s or family’s co-payments reach a certain level
medicare disadvantages
- No choice of doctor for in-hospital treatments
- Waiting lists for many treatments
- Does not cover alternative therapies
- Often does not cover the full amount of a doctor’s visit
